.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Femoral Shaft Fractures in Children Age 1-5 years Treated with Single Leg Walking Spica, Our Experience
Keywords:
LLD (leg length discrepancy), femur shaft fracture, varus, valgus, hip spica.Abstract
Introduction: Femoral shaft fractures are common in children. These fractures are classified according to the area of fracture involved. The treatment of femoral shaft fractures depends upon the age of patient. In children less than 6 years of age, hip spica is the treatment of choice.
Methods: this prospective study was conducted in orthopedic unit DHQ hospital Khar Bajaur and Orthopedic department Peshawar Medical College, Peshawar from July 2020 till June 2021. All patients fulfilling the inclusion criteria were enrolled in the study. Single leg hip spica were applied by two experienced orthopedic surgeons. Followup was done. Spica was removed after 6 weeks.
Results: A total of 31 patients were enrolled in the study. Mean age was 3.8 years. 58% patients were male and 42% were female. 58.1% had middle 1/3rd femur shaft fracture. LLD was the most common complication (9.7%).
Conclusion: Single leg hip spica is simple, efficient and cost effective treatment for children less than 5 years of age.
References
Jaafar S, Sobh A, Legakis JE, Thomas R, Buhler K, Jones ET. Four weeks in a single-leg weight-bearing hip spica cast is sufficient treatment for isolated femoral shaft fractures in children aged 1 to 3 years. Journal of Pediatric Orthopaedics. 2016;36(7):680-684.
Bridgman S, Wilson R. Epidemiology of femoral fractures in children in the West Midlands region of England 1991 to 2001. J Bone Joint Surg Br. 2004;86:1152–1157.
Rewers A, Hedegaard H, Lezotte D, et al. Childhood femur fractures, associated injuries, and sociodemographic risk factors: a population-based study. Pediatrics. 2005;115:e543–e552.
Ferreira JV, Thomson JD. Socioeconomic implications of spica casting: Commentary on an article by Dirk Leu, MD, et al.: “Spica casting for pediatric femoral fractures. A prospective, randomized controlled study of single-leg versus double-leg spica casts”. J Bone Joint Surg Am. 2012;94:e107.
Mehmood MS, Shah S, Razzaq S, Karim, A, Haq AU, Sabour A. Frequency of limb shortening in femoral shaft fractures treated by hip spica casting in children in Tertiary Care Hospital. Professional Med J 2019; 26(11):1873-1877. DOI: 10.29309/TPMJ/2019.26.11.3048.
Podeszwa DA, Mooney JF III, Cramer KE, et al. Comparison of Pavlik harness application and immediate spica casting for femur fractures in infants. J Pediatr Orthop. 2004;24:460–462.
Winter RB. Lovell andWinter’s Pediatric Orthopaedics. Philadelphia,PA: Lippincott-Raven; 1996.
Rockwood CA. Rockwood and Wilkins’ Fractures in Children, 6th edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2006.
Hughes BF, Sponseller PD, Thompson JD. Pediatric femur fractures: effects of spica cast treatment on family and community. J Pediatr Orthop. 1995;15:457–460.
DiFazio R, Vessey J, Zurakowski D, et al. Incidence of skin complications and associated charges in children treated with hip spica casts for femur fractures. J Pediatr Orthop. 2011;31:17–22.
Mubarak SJ, Frick S, Sink E, et al. Volkmann contracture and compartment syndromes after femur fractures in children treated with 90/90 spica casts. J Pediatr Orthop. 2006;26:567–572.
Aksahin E, Celebi L, Yuksel HY, et al. Immediate incorporated hip spica casting in pediatric femoral fractures: comparison of efficacy between normal and high-risk groups. J Pediatr Orthop. 2009;29:39–43.
Kesemenli CC, Memisoglu K. Immediate incorporated hip spica casting in pediatric femoral fractures: comparison of efficacy between normal and high-risk groups. J Pediatr Orthop. 2010;30:e5
Epps HR, Molenaar E, O’connor DP. Immediate single-leg spica cast for pediatric femoral diaphysis fractures. J Pediatr Orthop. 2006;26:491-6.
Flynn JM, Garner MR, Jones KJ, D'Italia J, Davidson RS, Ganley TJ et al. The treatment of low-energy femoral shaft fractures: A prospective study comparing the "walking spica" with the traditional spica cast. Journal of Bone and Joint Surgery - Series A. 2011 Dec 7;93(23):2196-2202.
Barry JSM. Paediatric femoral fractures. London: Springer; 2015. 89-103 p.
Brown D, Fisher E. Femur fractures in infants and young children. American journal of public health. 2004; 94(4):558-60
Kanaan Mansoor SS, Ali Ahmad, Muhammad Mustafa Arif, Muhammad Hamza. Epidemiology of childhood fractures in the city of karachi. jamc. 2015; 27(3):4.
Khalid Muzzafar RS, Suhail Ahmad Bhat, Muhammad Haseeb, Abdul Ghani. Early result of pediatric shaft femur fractures treated by hip spica cast in children upto 10 years of age. International Journal of Research in Medical Sciences, [Sl],v5,n6,p2430-2432, may 2017 ISSN Available at: Date accessed: 19 Jan 2018 doi:http://dxdoiorg/1018203/2320-6012ijrms20171993. 2017;5(6):2.
Buehler KC, Thompson JD, Sponseller PD, Black BE, Buckley SL, Griffin PP. A prospective study of early spica casting outcomes in the treatment of femoral shaft fractures in children. Journal of Pediatric Orthopaedics. 1995; 15(1):30-5.
Heinrich SD, Drvaric DM, Darr K, MacEwen GD. The operative stabilization of pediatric diaphyseal femur fractures with flexible intramedullary nails: A prospective analysis. Journal of Pediatric Orthopaedics. 1994; 14(4):501-7.
